Correlation between nasopharyngeal carcinoma tumor volume and the 2002 International Union Against Cancer tumor classification system.
Correlation between nasopharyngeal carcinoma tumor volume and the 2002 International Union Against Cancer tumor classification system.
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DOI：
10.1186/1748-717x-8-87
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发表时间：
2013-04-11
期刊：
影响因子：
--
通讯作者：
Huang SM
中科院分区：
文献类型：
--
作者：
Wu Z;Gu MF;Zeng RF;Su Y;Huang SM
探讨原发肿瘤体积与鼻咽癌(NPC)UICC2002、T分期、N分期及放疗后远处转移的关系，为肿瘤体积纳入TNM分期系统提供进一步依据。对2001年2月至2008年12月收治的666例鼻咽癌调强放疗患者的临床资料进行回顾性分析。根据治疗计划计算机断层扫描计算原发大体肿瘤体积。连续变量比较采用Kruskal-Wallis和Mann-Whitney检验，分类变量比较采用卡方检验。多因素分析采用Logistic回归模型。原发灶平均体积为20.35ml0.44 − 192.63 ml.随着T分期的增加，肿瘤体积逐渐增大。不同T分类患者的肿瘤体积差异有统计学意义(p <； 0.001)。颈淋巴转移率为64.7%(430/666)，原发灶体积有无转移者与有转移者相比差异有统计学意义(p <； 0.001)。100例鼻咽癌患者治疗后发生远处转移，5年无远处转移生存率为84.2%。单因素和多因素分析显示，N分期(p <； 0.001)和肿瘤体积(p = 0.007)是影响远处转移的主要因素。鼻咽癌放疗后肿瘤体积与T分期、颈淋巴结转移和远处转移相关，提示肿瘤体积应纳入TNM分期。
The correlation between primary tumor volume and nasopharyngeal carcinoma (NPC) UICC 2002 T classification, N classification and distant metastasis after radiation therapy was discussed to provide further evidence for the inclusion of tumor volume into the TNM classification staging system. Between February 2001 and December 2008, 666 patients with NPC treated with intensity-modulated radiation therapy (IMRT) were analyzed retrospectively. Primary gross tumor volume was calculated from treatment planning computed tomography scans. The Kruskal-Wallis and Mann–Whitney tests were used for comparison of continuous variables and the chi-square test was used for categorical variables. A logistic regression model was used for multivariate analysis. Median primary tumor volume of the 666 patients was 20.35 ml (range, 0.44 − 192.63 ml), and it gradually increased with T classification. Statistically significant differences in tumor volume were observed between patients with different T classifications (p < 0.001). The cervical lymph node metastasis rate was 64.7% (430/666); the differences in primary tumor volume between patients with or without lymph node metastasis were statistically significant (p < 0.001). Posttreatment distant metastasis occurred in 100 NPC patients, and the five-year distant metastasis-free survival was 84.2%. Univariate and multivariate analyses showed that N classification (p < 0.001) and tumor volume (p = 0.007) were the main factors influencing distant metastasis. Tumor volume was correlated with T classification, cervical lymph node mestastasis and distant metastasis after radiation therapy in nasopharyngeal carcinoma, suggesting that tumor volume should be included into the TNM staging system.